Provider Demographics
NPI:1962609198
Name:MCPHERSON-RICHARDSON, CYNTHIA J (LPC)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:J
Last Name:MCPHERSON-RICHARDSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10532 AUTO MALL PKWY
Mailing Address - Street 2:
Mailing Address - City:DIBERVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39540-3708
Mailing Address - Country:US
Mailing Address - Phone:228-828-5208
Mailing Address - Fax:228-220-4303
Practice Address - Street 1:10532 AUTO MALL PKWY
Practice Address - Street 2:
Practice Address - City:DIBERVILLE
Practice Address - State:MS
Practice Address - Zip Code:39540-3708
Practice Address - Country:US
Practice Address - Phone:228-828-5208
Practice Address - Fax:228-220-4303
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
MS3282101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00018214Medicaid